| NPI | 1982669248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301402369) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI GT402369) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2017-10-12 |